摘要
目的探讨脑出血合并应激性溃疡出血急诊内镜下诊治的可行性及效果。方法以我院收治的脑出血合并应激性溃疡出血患者中,经内镜下诊治42例作为内镜组,拒绝行内镜下治疗的68例为对照组,总结脑出血合并应激性溃疡出血患者内镜下表现,对比两组止血效果及病死率。结果内镜组患者内镜下主要表现为胃黏膜弥漫性糜烂伴渗血12例(28.6%),胃或十二指肠多发溃疡25例(59.5%),胃或十二指肠单发溃疡并出血5例(11.9%);消化道出血Forrest分级:Ⅰa 8例,Ⅰb 28例,Ⅱa 6例。内镜组消化道出血止血成功率(90.5%)较对照组(61.8%)显著增高(P<0.01),病死率(28.6%)较对照组(52.9%)显著降低(P<0.05)。结论脑出血合并应激性溃疡出血的急诊内镜下治疗安全可行,并且止血效果显著,能降低病死率。
Objective To explore the effects and feasibility of emergency endoscope for patients with cerebral hemorrhage complicated with stress ulcer. Methods The 42 patients with cerebral hemorrhage complicated with stress ulcer who were treated by emergency endoscope were regarded as the endoscopic group, and 68 patients were not treated by emergency endoscope were considered as control group. The endoscopic manifestations of cerebral hemorrhage complicated with stress ulcer were observed, and the hemostatic effects and case fatality rate were compared between the two groups. Results The main endoscopic manifestations of the endoscopic group were diffused erosion and errhysis of gastric mucosa（12 cases, 28.6%）, multiple ulcer of stomach or duodenum（25cases, 59.5%）, and single ulcer of stomach or duodenum（5 cases, 11.9%）. There were 8 patients with Forrest Ⅰa stage for alimentary tract hemorrhage, 28 ones with Forrest Ⅰb, and 6 ones with Forrest Ⅱa. The hemostatic rate in the endoscopic group（90.5%）significantly increased compared with that in the control group（61.8%）（P 〈 0.01）, while its case fatality rate（28.6%） significantly decreased compared with that in the control group（52.9%）（P 〈 0.01）. Conclusion The emergency endoscope is safe and feasible for the treatment of patients with cerebral hemorrhage complicated with stress ulcer, which can improve the hemostatic effects and decrease case fatality.
出处
《西南国防医药》
CAS
2016年第3期287-289,共3页
Medical Journal of National Defending Forces in Southwest China
关键词
脑出血
应激性溃疡
内镜
疗效
cerebral hemorrhage
stress ulcer
endoscope
therapeutic effect
